Abstract MP45: Beyond Pregnancy: Meta-Analysis of Lifestyle Intervention for Prevention of Diabetes Mellitus in Women With Prior Gestational Diabetes Mellitus

Abstract

Introduction: Among parous women,1 in 3 have a pregnancy complication, increasing chances of developing Diabetes Mellitus(DM), Hypertension, or heart disease. Lifestyle intervention is recommended to reduce cardiovascular morbidity risk after complicated pregnancies. The effect of lifestyle intervention on the risk of type 2 DM in women with prior Gestational DM (GDM) is not widely studied. Our study highlights the impact of lifestyle intervention on risk of type 2 DM in women with prior GDM. Methods: We ran a systemic literature search of PubMed, EMBASE, Clinical Trials.gov, and Google Scholar from January 2000 to August 2023 for relevant articles comparing lifestyle intervention (diet and physical activity) with standard care in women with prior GDM. The relative risk (RR) of DM with 95% confidence interval (CI) and p-values were extracted with fixed effect model using RevMan v.5.4. Results: Of 3100 articles that were screened, 28 underwent full-text review, and 11 studies met the inclusion criteria. Of 11 studies, 1661 were evaluated in intervention group (IG) and 1671 in control group (CG). The mean age of participants was 26.1-39 years, with a baseline body mass index (BMI) range (R) of 23.4-31.4 kg/m2 and a follow-up duration with R of 4-36 months. On analysis, the incidence of type 2 DM was 7.6% in IG compared to CG (10.35%). IG showed a 27% reduction in DM incidence as compared to CG, RR of 0.73(CI: 0.59-0.91) (p < 0.05) (Figure 1). On meta-regression analysis, duration of lifestyle intervention (R: 4-36 months) significantly impacted the observed reduction in incident type 2 DM (p < 0.05) (positive relation) as compared to baseline BMI (p = 0.21) (Figure 1). Conclusion: Our analysis highlights that lifestyle intervention in women with prior GDM positively reduces risk of type 2 DM, and intervention duration significantly impacts the long-term risk of DM and cardiovascular diseases. Further data is warranted from larger studies for stronger evidence regarding the benefits of lifestyle intervention in prior GDM patients